Treating India’s Suicidal Farmers

Indian farmer Gajendra Singh stands on a tree before apparently killing himself during an Aam Aadmi Party rally in New Delhi on April 22, 2015.

Chandan Khanna/Agence France-Presse/Getty Images

Under the blazing afternoon sun in June 2013, Narendra Kitukale a farmer in the western state of Maharashtra says he headed to a field of cotton he had sown by hand to kill himself.

Unable to bear the unexplained chronic neck pain and headaches he was suffering, he downed a bottle of pesticide.

His son found him lying in the field, Mr. Kitukale says, and rushed him to hospital.

"I did it because of money problems too,” he said on Wednesday, seated on a bed at his village home with wood planks, metal sheets and rubble surrounding him .

Nearly 225,000 people involved in farming and agriculture killed themselves in India between 2000 and 2013, the latest years for which data is available from the National Crime Records Bureau.

In recent months, in parts of the country where heavy, unseasonal rain and hail have damaged crops, hundreds of farmers have taken their own lives, according to Indian media reports.

On Wednesday, Gajendra Singh, a farmer from the state of Rajasthan died apparently after hanging himself from a tree at a political rally in New Delhi in support of farmers this week.

In response, Indian Prime Minister Narendra Modi described the problem of farmer suicide as “widespread” and “age old” in Parliament this week as he called on law makers to find cross-party solutions to the issue.

India has one of the highest rates of depression in the world, World Health Organization figures show, and because of a lack of psychiatrists and stigma around mental illness, particularly in rural swathes, many sufferers believe the only way out is to take their own lives.

In the case of Mr. Kitukale, worries over his cotton and lentil crops were compounded by costs for his two children's education, he says.

Other farmers told India Real Time this week that a sudden loss of a family member and a road accident had triggered bouts of depression.

Vidarbha, India's drought-prone, cotton-growing belt in eastern Maharashtra, has come to be known as the epicenter of the crisis: The state has registered the highest number of farmer suicides each year for over a decade, according to NCRB data.

Most of them occur in Vidarbha, according to nonprofits working in the area.

The Vidarbha stress and health program, or Vishram, has been supporting farmers and their family members in distress in the region since 2011. Its work is supported by funding from Tata trusts – the majority shareholder in India’s Tata Sons, a company which controls the diversified Tata Group of companies.

Cotton is a cash crop and so farmers growing it in this region have become vulnerable to fluctuations in global commodity prices, Dr. Patel said in an interview via Skype on Sunday.

"If the cotton price crashes, they all crash with it," he said.

The program, that offers treatment for all kinds of mental illness, is currently in operation in 30 villages, including Marlod, where Mr. Kitukale and his family live and where cows, goats and stray dogs mingle on unpaved streets.

To break taboos around mental illness and better inform villagers, Vishram holds regular workshops that include discussions and Bollywood film clips showing depression and alcohol abuse.

The aim is to trigger the community to act as a support network for people like Mr. Kitukale.

"Being alone and isolated leads to continuing depression," said Dr. Patel, who is also a professor at the London School of Hygiene and Tropical Medicine and co-founder of Goa-based mental health research nonprofit Sangath.

Vikram Patel, right, facing, meets with participants on the Vishram program in Maharashtra.

Sangath

People in leadership positions in the community and those with experience dealing with mental health issues are trained by the program to detect symptoms of mental illnesses and offer initial care. Patients are often referred by family members.

For Mr. Kitukale and his wife and their teenage children, the sarpanch - the elected head of the village - has played an important role in his on-going treatment, which began in Oct. 2013 with Vishram.

Further help, if needed, is offered by counselors - specially-trained staff members of a partner nonprofit called Prakriti.

They are tasked with first formally diagnosing depression or alcohol abuse, as well as assessing suicide risk.

If detected, further sessions are held to discuss the patient’s mental state.

Between April 2014 and January 2015, over 350 patients have met with counselors as part of the program. Of those, 90% were referred to counselors because of depression-related symptoms.

"The idea is to find a solution, to help patients out of the bad situation they are in," said Janrao Hawre, who is Mr. Kitukale's counsellor.

Has the number of suicides reduced in the participating villages since the program began? Vishram's intervention director Siddharth Gangale believes so, but doesn't have any figures so far to show this is the case. He says that the organization is compiling impact data to be ready in the coming days.

Funding for the program formally ends in October this year, but plans are in the works to implement another program, based on the Vishram model, to cover 1,000 villages in Maharashtra, Dr. Patel said.

In Mr. Kitukale’s case, there have “been a lot of improvements," his counsellor Mr. Hawre said, adding, "Before he would refuse to leave his house, wouldn't eat, couldn't sleep."

Now the pain in his back and neck, which doctors later diagnosed as physical symptoms of depression, is a lot less intense, Mr. Kitukale said.

Before the monsoon rains arrive in a few months, his attention is now focused on finishing renovating his house with funds received under a government social welfare program. "I'm adding a kitchen, a hall and in the front a bathroom," he said. At the moment his family doesn’t have such amenities. "I'll be happy when it's finished," he said.